AIDS Transmission Research Articles

CLINICAL AND LABORATORY STUDIES IN HOUSEHOLD CONTACTS OF PEDIATRIC AIDS CASES

During a 24 month period, ten children fitting the criteria of the immune deficiency syndrome (AIDS) and their household contacts were followed. Five of these children have died. All were born to parents where one or both had recognized risk factors for AIDS. Seven mothers and 3 fathers studied, were asymptomatic but only 3 had normal immune studies. There were 3 mothers and 2 fathers who were both symptomatic for AIDS and had abnormal immune studies compatible with AIDS. Five younger siblings of these 10 childhood AIDS cases and 3 foster mothers have remained asymptomatic and immunologically normal during this study period. This study suggests that first born infants to parents with AIDS risk factors are at the greatest risk of developing AIDS, most probably by vertical transmission of the AIDS agent. Transmission of AIDS from index children cases to other household contacts has not been demonstrated and such transmission appears unlikely to occur. These observations are significant in that intra-familial spread, if it does occur, is likely to be an infrequent event. This data should assist those AIDS patients requiring social services to find placement in homes or with agencies following discharge from hospitals.

THE SPECTRUM OF AIDS IN INFANTS. LACK OF EVIDENCE FOR INTRAFAMILIAL SPREAD

36 infants with AIDS or AIDS related complexes (without opportunistic infection) have been studied over a period of 4 years. In the last 17 months 12 patients developed opportunistic infections. The clinical and immunological spectrum of AIDS in infants is similar to that reported in adults. Some of the unique features in the pediatric age group are: recurrent parotitis, interstitial pneumonia without pneumocystic carinii and a higher incidence of bacterial infections preceding the development of opportunistic infections. Most infants (except for 3) were born to i-v drug using mothers who had (except for 3) an immunodeficiency suggestive of AIDS or a clinical disease meeting the CDC criteria for AIDS. Pediatric and adult household contacts of infants with AIDS were studied clinically and immunologically. In no instance was an older child found in the family or foster care home who had developed AIDS. In 2 families 4 children were found who had elevated serum IgG levels, 2 of whom had also reversed OKT4/T8 ratios. None of these children had any other immunological abnormality or clinical symptoms. This data argues against a transmission of AIDS by a casual or intimate-non-sexual contact.

ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) IN PEDIATRIC HEMOPHILIACS

Three of 35 U.S. children (<18 years old) with AIDS reported to the Centers for Disease Control (CDC) as of December 1983 had hemophilia. We summarize these and 2 European pediatric AIDS patients with hemophilia, reported to CDC. All 5 patients were white and male; ages ranged from 9-16 years. Four patients had severe hemophilia A; 1, moderate hemophilia B. Two cases resided in New York; 1, in Pennsylvania; the European cases were Spanish and siblings. Four patients presented with fever and weight loss; all had pulmonary symptoms. All cases had laboratory findings consistent with AIDS and had opportunistic infections (OI) including Pneumocystis carinii pneumonia, systemic cytomegalovirus, and systemic fungal infections. Three patients (60%) have died. None had other known risk factors for AIDS or immunosuppressive therapy. The hemophilia B patient received 2 units of whole blood in 1982 and no other blood products. Factor VIII was the only blood product received by both U.S. hemophilia A patients in the past 5 years. The prevalence of hemophilia in pediatric AIDS patients is much higher than its estimated population prevalence (1 in 10,000), indicating that hemophilia is a risk factor for AIDS. AIDS may occur in those receiving only factor or only whole blood therapy. Pediatricians should consider AIDS in any patient with hemophilia and unexplained weight loss, fever, or OI. To help further clarify the role of blood products in AIDS transmission, they should inquire about all product usage and other AIDS risk factors.

AIDS: An Occupational Hazard?

Dentists may be at unusual risk in the transmission of AIDS and special precautions are necessary.

AIDS transmission: what about the hepatitis B vaccine?

AIDS transmission: what about the hepatitis B vaccine?

Preventing AIDS transmission: should blood donors be screened?

Preventing AIDS transmission: should blood donors be screened?